Membership categories (see sidebar for membership descriptions):

Single Membership - $30 annually
Family Membership - $40 annually
Breeder/Stud Single Membership - $40 annually
Breeder/Stud Family Membership - $50 annually

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Name:

Address:

City: State: ZIP: Country

Home Phone: Cell Phone:

Email:

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List Family Members and their relationship to you [for Family Memberships only]

Family Member 1:

Family Member 2:

Family Member 3:

Family Member 4:

Family Member 5:

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In order to update our records, please list both the registered and call name of your Shiloh Shepherds. If you have more than five (5) Shilohs, please submit additional names under the comments section.

no change to our Shiloh Family from last year.

Registered Name: Call Name:

Registered Name: Call Name:

Registered Name: Call Name:

Registered Name: Call Name:

Registered Name: Call Name:

What is your Shiloh Shepherd Kennel name (if applicable):

What is your website address (if applicable):

Do you have breedable or potentially breedable Shiloh Shepherd adults or puppies? yes no

If so, may we contact you about listing your dog(s) on our club website? yes no

May we list your name on our public membership roster? yes no

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Additional comments:

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SELECT PAYMENT OPTION:
	On Line Payment
	Regular Mail Payment, I agree that my membership will be suspended in the event payment is not received in a timely manner.
	I agree to abide by the Constitution and Bylaws of the ISSDC, Inc.